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Chapter 3: Sleep-Related Breathing Disorders

What is Central Sleep Apnea Syndrome?

Central Sleep Apnea Syndrome (CSAS) occurs when breathing either stops (apnea) or is reduced (hypopnea) in persons with unobstructed upper airways.1 As a result of the central respiratory center’s failure to signal to breathe, the person’s breathing is diminished or stops repetitively for 10 seconds or more.

In contrast to Obstructive Sleep Apnea Syndrome (OSAS), where arousals are typically required to terminate the apnea, central apnea-hypopneas generally end gradually, when the signal to breath returns.2

Cheyne-Stokes breathing is characterized by apneas, hypopneas, or both, alternating with periods of excessive breathing (hyperpneas). This waxing and waning pattern distinguishes Cheyne-Stokes from other forms of CSAS.

Central Sleep Apnea Due to a Medical Condition Other Than Cheyne Stokes

Patients may develop CSAS from brain stem lesions of vascular, neoplastic, or other etiology. Others result from renal dysfunction.